Quinolone Antibiotics and Their Effects on our Mitochondria and Health

Fluoroquinolone (FLUORIDE!) antibiotics like Cipro and Levaquin have been getting plenty of negative press over the years for the mitochondrial damage that they can cause. The term “floxxed” has been used for the semi-permanent or permanent side effects of these antibiotics that some people have taken that have cost them their health. Fluoroquinolones are given out by the medical establishment like candy to treat bacterial infections. Instead of prescribing the antibiotic as a drug of last resort or at least “black-box” warning (the FDA finally assigned it to the antibiotics in 2016, “An FDA safety review has shown that fluoroquinolones, when used systemically, are associated with disabling and potentially permanent serious side effects that can occur together. These side effects can involve the tendons, muscles, joints, nerves, and central nervous system”) medication that should be used only when necessary. Between 1995 and 2002, fluoroquinolones became the most commonly prescribed class of antibiotics to adults in the United States. Fluoroquinolone prescribing rose from seven million visits in 1995 to twenty two million in 2002. Medicaid reimbursements for quinolones show that the prescribed amounts have maintained the same intensity. “The total annual number of quinolone prescriptions increased 402%, from 247,395 in the first quarter of 1991 to 1.2 million in the second quarter of 2015, peaking at 1.3 million in the first quarter of 2005.” In 2016, the FDA also recommended that the “serious side effects associated with fluoroquinolone antibacterial drugs outweigh the benefits for patients with acute sinusitis, acute bronchitis, and uncomplicated urinary tract infections who have other treatment options. For patients with these conditions, fluoroquinolones should be reserved for those who do not have alternative treatment options.” Many doctors still give it out for people with these conditions to this day, I see many clients and family members who have had these conditions, prescribed these antibiotics continuously. 1234

Quinolone antibiotics have been used for a long time, but since the late 2000’s, mitochondrial severe side effects have been more frequently reported. For some, quinolones appear to be well tolerated, and the average side effects include systemic allergic reactions, headaches, insomnia, diarrhea, and nausea. The main issues associated with the use of quinolone antibiotics are the issues related to mitochondrial dysfunction and GABA inhibition. Central nervous system toxicity, spontaneous Achilles tendon ruptures that can occur a couple of months after use (the increase in risk is associated with people over the age of sixty and athletic males), psychosis, cardiac arrhythmias (mainly prolonged QT syndrome), seizures, worsen symptoms of myasthenia gravis, peripheral neuropathy (oral and injection versions only), and hypoglycemia have been reported in more significant quantities as serious side effects in the 2000’s. People with a SOD2 (superoxide dimutase two gene) mutation, might have a greater negative mitochondrial reaction to quinolone antibiotics.56

The following is a list of fluoroquinolone antibiotics that have a higher chance to cause a multitude of side effects:

Moxifloxacin carries a higher chance of causing long QT syndrome and is associated with uveitis. 78

Temafloxacin, gatifloxacin, trovafloxacin, were withdrawn from the market because of adverse side effects. 13

Like some antibiotics, C. difficile dysbiosis is caused more often by quinolone antibiotics, and the strains of C. difficile associated with fluoroquinolone caused dysbiosis might be more virulent. 14

Most fluoroquinolones chelate magnesium and calcium from our microbiome and our cells. Though fluoroquinolones would bind with the magnesium in endotoxins and weaken Gram-negative bacterial cell walls and biofilm, it can also affect cellular and mitochondrial calcium and magnesium availability, causing hypomagnesemia and hypocalcemia. 15

There are many different mechanisms associated with causing people to become “floxxed” when they take fluoroquinolone antibiotics. Fluoroquinolones block GABAa receptor complex within the central nervous system which can cause glutamate excitability and increased oxidative stress cause the associated negative neural and nervous system symptoms. Anxiety disorders, seizures, and even psychosis have been linked to quinolones because of its interference with the GABAa receptors and GABA production. Fluoroquinolones deplete mitochondrial DNA in humans, reducing mitochondrial function and biogenesis. Fluoroquinolones also decrease brain serotonin levels which can induce mood destabilization (more prone to mania and depression) and circadian dysrhythmia (poor sleep and lack of energy). 161718

Our mitochondria are bacterial in origin, so it would make sense that many antibiotics that we use to target bacterial DNA would also to a lesser extent target mtDNA. Fluoroquinolones also interfere with the electron transport chain within our mitochondria and increase the formation of reactive oxygen species within our mitochondria and our cells creating unnecessary healthy mitochondria and cellular apoptosis. 1920

“The loss in mtDNA was associated with a delayed loss in mitochondrial function. Here, we report that the 4-quinolone drug ciprofloxacin is cytotoxic to a variety of cultured mammalian cell lines at concentrations that deplete cells of mtDNA.”21

“Studies have also suggested that 4-quinolones may interfere with cell growth by inhibiting mammalian mtDNA replication. Castora et al. found that the 4-quinolone drugs nalidixic acid and oxolinic acid inhibited mtDNA replication in isolated rat liver mitochondria. These investigators inferred that this effect might be mediated by the inhibition of a mitochondrial topoisomerase II activity related to the bacterial enzyme DNA gyrase.”22

“We recently demonstrated that the 4-quinolone drugs nalidixic acid and ciprofloxacin cause a selective loss of mtDNA in drug-treated mammalian cells. The loss of mtDNA was associated with a decrease in mitochondrial respiration and an arrest in cell growth. These results suggested that inhibition of mammalian cell proliferation by 4-quinolone drugs might be caused by the selective depletion of mtDNA, resulting in compromised mitochondrial activity. We now report that ciprofloxacin causes delayed cytotoxicity in cultured mammalian cells at concentrations that deplete cells of mtDNA.”23

“Quinolones target bacterial gyrases and mtDNA topoisomerases. First, we show that, regardless of their molecular targets, three major classes of bactericidal antibiotics – quinolones, aminoglycosides, and β-lactams—induce ROS production in mammalian cells, leading to DNA, protein, and lipid damage. Second, we demonstrate that these deleterious effects are produced by clinically relevant doses of bactericidal antibiotics, both in cell culture and in mice. These findings are analogous to our previous work in bacteria, in which we showed that clinically relevant doses of bactericidal antibiotics induce a common oxidative damage pathway.”24

Tendon ruptures occur from a lack of proper collagen synthesis in the tendons and increased oxidative stress and inflammation. Athletes have been cautioned not to take quinolones if possible because it inhibits homeostasis and tissue repair in their tendons and can lead to ruptures.

The pathways underpinning the tenotoxic effects of fluoroquinolones are unclear, but three main mechanisms have been proposed: ischemia, degradation of the tendon matrix, and adverse alteration of tenocyte activity. Matrix metalloproteinases are enzymes with degrading properties that are important in the homeostasis and response to injury of tendon tissue. Fluoroquinolones facilitate expression of matrix metalloproteinases in tendon tissue; ciprofloxacin, in particular, has been shown to increase the expression of matrix metalloproteinase-3 in human Achilles tendon-derived cells and to reduce collagen synthesis via inhibition of tenocyte proliferation.”25

Fluoroquinolones in some people may induce hypoglycemia by increasing insulin release in the pancreas by blockading the ATP sensitive potassium channels in the beta cells of the pancreas. Improper insulin over release into the bloodstream metabolizes blood glucose dropping it to low levels creating hypoglycemia. The mechanism of action for quinolones to cause hyperglycemia is currently unknown. 2627

I do not recommend using fluoroquinolone antibiotics unless necessary and if you do need to use them, follow the listed protocol to see if you can protect your mitochondria as much as possible when you are taking them. I also recommend that quinolones should only be used in children as a drug of last resort because of the potential risks associated with arthropathy (joint health issues) in children with proper studies. The FDA limits quinolones usage in children only for serious medical necessity:

“Currently, FQs that are approved by the U.S. Food and Drug Administration (FDA) for use in children include ciprofloxacin for the treatment of inhalation anthrax, complicated urinary tract infections, and pyelonephritis along with levofloxacin for inhalational anthrax and plague.”28

Finally, work with your doctor on trying to use the lowest dose possible and avoid some of the fluoroquinolones listed above that are associated with severe side effects if you must use quinolones.

Recommendations to Help Reduce Quinolone Mitochondrial Toxicity

Supplement with magnesium regularly. Magnesium will increase mitochondrial function and ensure proper GABA production and reduce glutamic acid neurotoxicity. Take magnesium separate from quinolones because of their magnesium chelation effect.

Quinolone antibiotics deplete glutathione, so you might want to supplement with it to protect the liver and mitochondrial health.

14 Comments

I agree with every story above especially the part about how evil Bayer are. I contacted them five times and was told five times to go back to my Doctor who poisoned me in the first place and didn’t have a clue what to do. These drugs are far from ‘rare’ and I’m sick to death of continually screaming about this to anyone who will listen to get some recognition of what’s happened to us all. And to stop others from being damaged for life. Even after four Black Box warnings from the FDA and warnings from the EMA this poison is STILL being precribed. It’s a CRIME AGAINST HUMANITY.

Bayer execs should rot in Hell! Only now since they are being sued by many patients, have they finally issued advisories to doctors to no longer prescribe cipro for UTIs.

Bayer’s conduct in knowingly concealing the very serious adverse effects of fluoroquinolones is not only unconscionable and irresponsible but also unethical. However, Bayer is not the only party at fault. Physicians are responsible for paying attention to warnings and advisories and apparently, many are still not getting the message.

Big pharma tells physicians to ignore patients like me who swear up and down that we were fine until being given that drug. We as patients should be able to trust our doctors. That trust has eroded for me since the day I was given cipro in 2013 and even moreso in 2015 when an allergist was dismissive over my belief that cipro was the culprit for my sudden health issues.

My story is unusual in that it turns out that ciprofloxacin was contraindicated for me as it turns out that I have Ehlers Danlos Syndrome. Fluoroquinolones damage connective tissues. With EDS, my connective tissues are already weakened. The silver lining for me is that at least now I know that I have EDS.

This does not mean that Bayer should not be held liable for negligence. Bayer owed a duty to us patients and breached that duty by concealing known adverse side effects to our physicians, who in turn were unable to communicate these effects to us. That breach of duty is the proximate cause of our injuries. But for ciprofloxacin, I would not have a leaky gut. I would be able to eat normally. Bayer’s negligent conduct has resulted in damages including medical bills for multiple specialists plus physical therapy plus economic loss for having to work as a contractor in order to have the flexibility to see so many providers.

If it sounds like I am an attorney, it is because I am albeit I can’t practice as a result of the brain fog I developed after taking ciprofloxacin. Until then, my memory was sharp. Now, my short-term memory is noticeably impaired.

the vast majority of folks who take this class of drugs have no adverse reactions. typically what you hear are those who’ve been negatively impacted as they are more motivated to tell their stories so others don’t fall into a similar situation.

still this class of drug does seem to have a lot more negative impacts than others so buyer beware. i think this article provides some solid understanding of the negative effects as well as how to minimize so rounded from that perspective which is good.

This is FAR more common than anyone least of all the medical profession realises Rich. I know so, as I have been in this world we inhabit for almost as long as these dangerous drugs have been on the market.

Fluoroquinolone toxicity is certainly NOT rare, its not rare at all, instead it is invariably mistaken & misdiagnosed as MANY other things . Often this will be a syndrome, one such as such as fibromyalgia, it can be misdiagnosed as CFS / ME, various autoimmune conditions ‘ severe mental illness ‘ … & the list goes on ad infinitum.
What IS rare instead, is Drs & patients recognising this iatrogenic injury for what is REALLY is, a serious multi systemic adverse drug reaction.

The FQs come with an insidious sting in the tail, damage caused from the FQs often presents as delayed ADRs, which can occur many weeks, to many months or even later down the line… AFTER finishing the prescription, therefore nobody, least of all the medical profession invariably will connect those FQ dots to that harmless sounding ‘ antibiotic’ ( they are actually failed chemo drugs, topoisomerase inhibitors ) taken many months before by their patient.
The patient is instead due to symptom profile, all too often sent off on a wild goose chase, sent from from Dr to specialist often for years on end, where they are all too often misdiagnosed, getting further damaged by other pharmaceuticals prescribed for those conditions they do not actually have .

it is also VERY important to note the following : that there are NO better tolerated than other FQs when it comes to their serious toxic profile, & their potential for resulting in serious harm. ALL FQS, no matter WHAT the dose, OR whatever mode of administration, ( & this includes the topical versions, the ear & eye drops ) are capable of causing exactly the same damage.

I would strongly recommend myself, that these so called ‘ antibiotics ‘, are avoided like the plaque on humanity they invariably are, unless ALL other antibiotic choices available for the bacterial strain concerned have been exhausted, & the ONLY other choice you have to them is death. They are THAT dangerous, & they are quite capable of destroying forever your one & only precious life as you presently know it, as I, & countless others, many of us now permanently damaged, at least those of us who HAVE joined those FQ dots, unfortunately now know to our cost .

Rich,
With respect, I would like to know how you know that the majority of folks don’t have an adverse re action to fluroquinolones. It’s well documented that these drugs are cumulative, that most re actions are not reported because in some cases people have no idea what’s happened to them until months later or never find out and are diagnosed with fibromyalgia. I had taken cipro at least 3 or 4 times before I was devastatingly effected and did not find out what had happened to me until SEVEN months later when a Rheumatologist took my medical history and was well aware of the horrendous side effects. I never dreamt the reason I couldn’t walk was because of an antibioctic given to me for a bout of bronchitis. I would have never known had it not been for this Rheumatologist. So please in future before you give an opinion on such an important issue, get your facts right

Third time floxed, didn’t realise till after second time, reported symptoms to Gp at Carden Medical Centre, Aberdeen, while can prove conversation later found never noted at time as was told would be. 8 years later drug given again. Two pills about killed me,body went south over next 4-6 months ending in being bedded mist if time, numerous symptoms developed, body a shadow of former self, these drugs age your body, bring on variety if medical problems and can cause major damage, in meantime while living a major living hell, the medical community ridicule, collude, lie, gaslight and offer little constructive help to way body been left…

Thanks for this excellent article about fluoroquinolones, or FQs. The original quinolones were all taken off the market for being too toxic. The addition of fluorine made the drugs far better at penetrating through membranes and into difficult to reach places, like in bone marrow, so they were able to reduce the amount of the drug needed to kill bacteria throughout the body. The good news was that this made the quinolones a viable medication. The bad news was that the severe adverse reactions did not stop happening, they just became delayed in the vast majority of cases. What this means is that there are huge numbers of people who have had adverse reactions to Cipro, Levaquin, Avelox and others, but they haven’t made the connection. Who thinks of the antibiotic they took several seasons ago when their tendons rupture spontaneously or their cartilage melts or their lung collapses or they get projectile vomiting or they get anxiety attacks or a muscle tears or they get a hernia or they get severe brain-fog or insomnia or chronic fatigue or tinnitus or visual disturbances or seizures and shaking of all sorts or they lose their sense of balance or their perception of time or they have heart palpitations or any of hundreds of other things go wrong. Those things all happened to me, and many more. It is impossible to exaggerate how horrible getting floxed really is. This might be the single most horrific thing a group of people have ever had to endure. There is an overwhelming sense of doom that can’t be described or explained.

Doctors routinely misdiagnose their victims with lupus or fibro or ALS or Parkinson’s or MS or Gulf War Syndrome or any of dozens of other conditions that it is not. Not only does this mean that we don’t get the treatment we need, not that there really is any, but it also means that we will often end up taking more toxic chemicals prescribed to us for conditions we don’t actually have resulting in further damage to our already severely compromised systems. Worse yet, it also means that we are padding the numbers of all these various conditions, which are not as common as they try to tell us they are. Fluoroquinolone toxicity, however, is incredibly common, with millions upon millions of sufferers in the US alone and tens of millions globally. Sadly, though, 99.99% of these “floxies” have no clue what went wrong but word is getting out. Slowly but surely we are gaining momentum. Our support groups are exploding and newscasts are becoming more and more common. It’s just a matter of time until we get the national and international news coverage we deserve at which point this will become one of the biggest news stories of our generation. This is a massive ongoing crime against humanity. The executives of the giant transnational drug dealing corporations that are doing this to people should die behind bars, preferably at a date and time set by the court. Yes, the CEO’s of Bayer and J$J deserve the death penalty for crimes against humanity, plain and simple.

I urge everyone who reads this to read their posts as well and to google key words from this excellent article and from the conversation here and follow where they go. You will be stunned by all the articles and newscasts and books and videos and websites and lawsuits and non-profit foundations and blogs and so on. This is the thalidomide story of our generation, just breaking now. Thanks, Fix Your Gut for doing your part to raise awareness. Best wishes to all!

The millions of people in pain that are under treatment with opioids are being told by their PC Docs, sorry, I don’t want to treat you any longer even though I’m the one that gave you these meds 6-8-10 times over the years for sinus infections. I know you are chemically dependant on these pain meds I’ve been giving you for 10 years for something we decided was fibromyalgia. I hope you can find a pain Doc that has space available as most PC Docs are not willing to stand up to tell the FDA, I’m treating this person because they were poisoned by these medications the drug reps have told us for years, “they work great on sinus and UTI’s, your patients will love you” until you hear from the ER Doc they are in the ER with a blown tendon in their heel while walking the dog. Or worse, they were caught stealing pain pills from someone’s medicine cabinet, or loose pills in the cup holder of their car. This will occur to the point, it will overflow the courts as well as the lack of Docs willing to prescribe pain medication to those who have had several tendon ruptures who have peripheral neuropathy…..head to toe pain! What will they do. It will be great for funeral homes, casket makers and florists! A devout libertarian, I don’t like the government in our business. The FDA needs to fix this and very soon. Mexico will increase their poppy fields, many will die.

Please do a study on the REAL effects the eye and ear drops have in one’s body as the FDA and doctors say they do NOT harm you. I was Floxed in the 90s by various pills and IVS and was pretty harmed by them. I didn’t connect the dots til 1998. In 2013 during a surgery at Duke University in NC unbeknownst to me (although it was written all over my paperwork NO FQs) the surgeon used Ofloxacin ear solution and steroids. As I was being discharged the next day I was wondering why all my Floxed symptoms were suddenly heightened but thought it was the anesthesia. It wasn’t until a week later when I got a copy of the operative report that it stated the solution was used. Then I knew exactly why I was so sick and at 62 at the time it was much harder to deal with. The dr felt that the small amount she used couldn’t do anything to me but I showed her the insert for the ear drops. DO NOT USE IF HYPERSENSITIVE TO ANY QUINOLONES IN ANY FORM. She still wouldn’t believe me and since 2013 no other doctor does either.

I can’t imagine what these ear and eye drops are doing to our kids as they are always being given them.

I want to post some of my story after taking Cipro… Immediately after taking Cipro I had Extreme flu like symptoms / brain fog / and even on & off- Paralyzed once I sat down. This was all a few days into my taking Cipro. Once I moved to Italy…Seeking help for my health I could no longer eat & in approx. a month my weight went from 215lbs to 155! I was in bed 20 hours a day. I lost hearing in one ear. My body temp could no longer be kept up anymore. A couple months into my taking Cipro I had Fluoroquinolones induced Psychosis which caused 3 or 4 CRISSES where I tried to end it! I live in mental institution here in Italy now…I am forced to take Lyrica & have side effect of …Collapsing … I trying to go w/ less Lyrica now…This all started after taking Cipro at the end of 2008… is Now March 2017…its NOW…2018.. off all Lyrica.. and less last med.. on a nutrient dense diet.. taking ..Ester C / Vit D3 and a mix of 4 Magnesium…I HAVE more.. energy.. BETTER focus.. a LOT LESS…anxiety & stress.. DEFINALTY HEAlING from FQ Toxicity!!!

This is my second time being floxed, what a struggle this has been. To finally find out what was causing this sickness. It’s giving me tachycardia, depression, mania, fatigue and burning. I pray for those who have been damaged and pray that the number of people going on these can go down, and hopefully be taken off the shelves ASAP

I am so grateful for this thoughtful and thorough article about the extreme dangers of Fluoroquinolone antibiotics. I am just one of many who now suffer with daily chronic pain. Every joint and tendon in my body hurts and I have peripheral neuropathy in both of my arms. I was severely poisoned and not one of my doctors believes me and if I even mention Cipro, they tell me “surely it’s out of your by system now” and then try to tell me I have fibromyalgia just to get me out of their office.
Thank you also for adding the extra warning about giving children these drugs. This is also true for anyone over the age of 60 as well. Please be careful, FQs are in their ear drops and eye drops too (think cateract surgery) and veterinarians are also floxing your pets. You must insist on a non-fluoroquinolone antibiotic as doctors do not like to be corrected. Unless it’s life or death, they shouldn’t be prescribing it them. Read the RX hand out, it’s all there in a the fine print!
Please, read your RX warnings, ask questions, do your own drug interaction check on line…and never ever take Fluoroquinolones with steroids, NSAIDS, beta blockers or Celexa..and many others. Do not rely on your doctor or pharmacist to check for interactions, because they don’t. PLEASE TAKE HEED OF THIS WARNING.

I was severely poisoned over the past 30 years. Had years for medical bills and constant illness after repeated Quinolone prescriptions. NEVER got a diagnosis or medical care for the poisoning I was enduring. I have only found some relief after finding out that I was being repeatedly poisoned and stopping Quinolones and getting help from the Fluoroqinolone Toxicity Facebook groups. It has been a nightmare. That unknowingly ruins lives.

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About John Brisson

John Brisson is the author of Fix Your Gut: The Definitive Guide to Digestive Disorders. Due to his extensive knowledge on the subject of gut health, John has been tapped by prominent supplement companies as an educator and collaborator on product formulation. As a lifestyle counselor, he has logged thousands of hours assisting people with digestive disorders and coaching them to improve their overall health. John applies his experience and ample research full-time to the construction of a dynamic, evolving database of actionable, evidence-based information on digestive health. Beyond what can be readily accessed on his website and in his definitive e-book, supplementary info from John can be found all over the web in his activity on various health information hubs and forums (including his own Fix Your Gut Forum).